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0213U006565,
0111U001373
,
Substantion of working out of organoprotective technologies of anesthesia and intensive therapy in the patients of defferent age in urgent and critical states
Klygunenko Olena Mykolaevna; Snisar Volodymyr Ivanovich,
19-11-2013
Dniepropetrovsk State Medical Academy
Based on the study of the basic mechanisms of the critical state caused by severe burns reasonable means and methods of perioperative orhanoprotektornoyi intensive therapy in the acute period of burn disease is aimed at preventing the development of multiple organ failure and decrease of organ dysfunction. Performing a phased algorithm providing medical assistance to victims of severe thermal injury reduces the duration and severity of burn shock , reduces the period of burn toxemia , enables early surgical treatment of burns and uncomplicated course of burn disease in 97.4 % of patients with ITT to 90 units. , At 79, 5 % - from ITT 91-120 units. and 55.1% - from ITT>121. , reduces mortality.Studied and analyzed systemic inflammatory response syndrome in patients with multiple trauma. It is proved that intensive care of ahead of recombinant interleukin -2 in patients with multiple skeletal injuries dominance reduces the number of early infectious complications of traumatic disease 1.8 times , particularly pneumonia - 2.4 times , lower average bed-day in the ICU - 2.2 times . that in patients with multiple trauma on the background of dominance ahead of abdominal tsytokinoterapiya reduces the incidence of complications TX 2 times, correlated with a decrease in cases of abdominal sepsis , significantly reduces the length of stay of patients in VAIT 2.1 times , total duration of treatment - 1.6 times , significantly reducing mortality of 2.0 times.By studying the effect of different choices of anesthesia on hemodynamics , pain level , markers of inflammation and hemostasis proved the rationality of the methods of epidural and spinal anesthesia during surgery in general and plastic surgery due to lower levels of postoperative pain and intraoperative blood loss and anti-inflammatory properties. The use of epidural anesthesia during surgery in general and plastic surgery creates less energy-intensive type of hemodynamics , normalizes vascular tone, reduces the load on the myocardium , reduces the severity of pain within 1 day after surgery, providing anti-inflammatory effect up to 5 days after surgery. At the same time stabilizing the coagulation system and fibrinolysis in the activation of endogenous anticoagulant system that not only reduces intraoperative blood loss , but also decreases the patient's stay as a bed intensive care unit of 2 , total bed days (from 6,1 ± 2,2 to 5 2 ± 0,3, p = 0,01).Based on the research dopplerohrafichnyh indicators of cerebral blood flow , assessment of cerebral perfusion and systemic hemodynamics and optimization of mechanical ventilation proved the benefits of respiratory therapy and fence safety in term infants with the need to vent support against development of hypoxic- ischemic encephalopathy. Developed and implement algorithms respiratory support have reduced mortality among term infants from severe intrapartum asphyxia and its complications in 5 times.
Доценко Владислав Валерыйович
Капустіна Оксана Григорівна
Матолінець Наталія Василівна
Сорокіна Олена Юріївна
2020-04-02
Updated: 2025-12-13
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